2024-03-26T07:47:37-05:00 2023-06-30 010523282 Berry Dunn McNeil & Parker LLC 2211 Congress St Portland ME 04102 990 2022-07-01 010369195 Maine-Dartmouth Family Medicine Residency MAIN 2076261894 15 East Chestnut Street Augusta ME 04330 Michelle Bragg Executive Director 2076261894 2024-03-21 1 Michelle Bragg XXX-XX-XXXX 1 Joseph R Byrne P01289281 2077752387 2024-03-21 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Michelle Bragg 15 East Chestnut Street Augusta ME 04330 20959267 0 X www.mainedartmouth.org X 1980 ME Maine Dartmouth Family Medicine Residency is a post-graduate medical education/training facility. 20 17 158 17 0 0 3000 3500 20382644 20332053 115740 19055 0 0 20501384 20354608 0 0 0 0 18618371 19472070 0 0 0 1457990 1443160 20076361 20915230 425023 -560622 6352480 6490816 3376397 4013969 2976083 2476847 X Educate physicians for a lifetime of competent, compassionate and personally satisfying practice. Improve the health of Maine people, with particular emphasis on rural areas and underserved populations. Promote the involvement of physicians in the life of the broader community. 0 0 18236731 20332053 The Maine-Dartmouth Family Medicine Residency is an education based program that educates physicians for a lifetime of competent, compassionate and personally satisfying practice. The Organization strives to improve the health of Maine people with particular emphasis on rural areas and underserved populations while promoting the involvement of physicians in the life of the broader community. The Organization creates a community of learners which honors patient care responsibilities, balances learning and patient care in a way that combines scientific rigor and humanity and values the community caregivers.The Organization strives to create a workplace culture that fosters respect, teamwork, support for personal well-being and openness and appreciation for difference. 18236731 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 16 0 1 158 1 0 0 0 0 0 0 0 0 0 0 0 0 X 20 17 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Michelle Bragg 2076261894 15 East Chestnut Street Augusta ME 04330 Steven E Diaz MD Chair 1.00 X X 0 0 0 Amy Tardiff Esq MBA Vice-Chair 1.00 X X 0 0 0 Terry Brann Treasurer 1.00 X X 0 0 0 Chuck Hays Secretary 1.00 X X 0 0 0 Richard F Hobbs III MD Director/Preceptor 13.49 X 37003 0 0 James Schneid MD Director/Preceptor 0.41 X 1925 0 0 Thomas Pentzer DO Resident 1st Half 40.00 X 62349 0 26136 Miriam Uduebor MD Resident 2nd Half 40.00 X 62980 0 8042 Cathy Bourque Director 1.00 X 0 0 0 Elizabeth Foley Director 1.00 X 0 0 0 Cassandra Generlette MD Director 1.00 X 0 0 0 Judi Hawkes Director 1.00 X 0 0 0 Philip Heywood Director 1.00 X 0 0 0 Cathy Morrow MD Director 1.00 X 0 0 0 Jennifer Riggs RN Director 1.00 X 0 0 0 Stephen Sears MD Director 1.00 X 0 0 0 Alex Sydnor MHA Director 1.00 X 0 0 0 Forrest West MD Director 1.00 X 0 0 0 Elisabeth Wilson MD MPH MS-HPEd Director 1.00 X 0 0 0 Christinia Zimmerman DO Director 1.00 X 0 0 0 Lorraine McCabe Past Director 1.00 X 0 0 0 Michelle Bragg EdD Executive Director 40.00 X 161418 0 11565 Kathryn Hoffmann DO FM Program Director 40.00 X 267847 0 39210 Andrew J Dionne MD Director of Clinical Medicine 20.00 X 20282 0 260 Megan Barker MD Director of Faculty 40.00 X 240955 0 47006 Stephanie Bartholomew MD Director of Clinical Medicine 40.00 X 249137 0 38600 Donald Woolever MD Past Residency Director 40.00 X 377096 0 16434 Kate Anderson MD Director of Education 40.00 X 240710 0 43614 Joshua Sparling MD Dermatology Physician 40.00 X 458094 0 44190 Jill Colvin MD Dermatology Physician 31.00 X 376500 0 41012 Robert Kenney MD Dermatology Physician 26.50 X 311067 0 19880 Christopher Lutrzykowski MD Program Director Sports Medicine 40.00 X 287748 0 38666 Elizabeth Rothe MD Assoc. Program Dir. Sports Medicine 40.00 X 280782 0 19493 3435893 0 394108 57 0 1 0 0 3500 3500 Residency Revenue 611600 20316768 20316768 Miscellaneous Revenue 611600 15285 15285 20332053 74959 74959 548755 604659 -55904 -55904 -55904 20354608 20332053 0 19055 1952569 1377353 575216 14808227 13218889 1589338 609542 553153 56389 1099280 989389 109891 1002452 884732 117720 3400 3083 317 28920 28920 13573 11537 2036 103489 103489 81414 71180 10234 990 495 495 193981 53157 140824 83011 79571 3440 257752 243051 14701 12480 6240 6240 364224 352112 12112 Licenses 86815 71285 15530 Dues and Subscriptions 83929 76792 7137 Miscellaneous Expense 80609 65932 14677 Recruitment 48573 46371 2202 20915230 18236731 2678499 0 X 300 300 1186022 1319064 46348 49695 132885 178662 277743 243647 35036 34096 2628090 2044059 2323799 2864940 6352480 6490816 1052598 1149029 2323799 2864940 3376397 4013969 X 2976083 2476847 2976083 2476847 6352480 6490816 -560622 61386 0 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 4249 4249 0 Part II-B, Line 1: The Organization pays dues to various organizations, a portion of which is attributable to lobbying expenses. 277743 243647 34096 34096 Deferred Compensation 2864940 2864940 Deferred Compensation 2864940 2864940 20415994 61386 61386 20354608 0 20354608 20915230 0 20915230 0 20915230 1 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 Schedule E, Part I, Line 3 The Organization includes its policy in the literature it provides to prospective students and in its advertising. X X X 1 0 0 0 0 0 0 1 0 Joshua Sparling MD Dermatology Physician 437596 0 0 0 20498 0 15599 0 28591 0 502284 0 0 0 Jill Colvin MD Dermatology Physician 336771 0 0 0 39729 0 16061 0 24951 0 417512 0 0 0 Donald Woolever MD Past Residency Director 290950 0 14500 0 71646 0 9107 0 7327 0 393530 0 0 0 Robert Kenney MD Dermatology Physician 309660 0 0 0 1407 0 14541 0 5339 0 330947 0 0 0 Christopher Lutrzykowski MD Program Director Sports Medicine 280248 0 7500 0 0 0 14430 0 24236 0 326414 0 0 0 Kathryn Hoffmann DO FM Program Director 257847 0 10000 0 0 0 15313 0 23897 0 307057 0 0 0 Elizabeth Rothe MD Assoc. Program Dir. Sports Medicine 272782 0 7500 0 500 0 15376 0 4117 0 300275 0 0 0 Megan Barker MD Director of Faculty 220205 0 5000 0 15750 0 14138 0 32868 0 287961 0 0 0 Stephanie Bartholomew MD Director of Clinical Medicine 237662 0 7500 0 3975 0 14433 0 24167 0 287737 0 0 0 Kate Anderson MD Director of Education 240710 0 0 0 0 0 14097 0 29517 0 284324 0 0 0 Michelle Bragg EdD Executive Director 153408 0 7500 0 510 0 8860 0 2705 0 172983 0 0 0 Part I, Line 4a Donald Woolever, Past Residency Director, received a severance payment in the amount of $58,750 during calendar year 2022. The payment was included in Mr. Woolever's 2022 Form W-2 and is reported as part of the amount shown on Form 990, Schedule J, Part II, column (B)(iii). Part I, Line 7 MDFMR Faculty can earn an annual bonus, awarded on a point system. Categories include advising, clinical, education, scholarship and professionalism. Bonus payment is not contingent on the revenues or net earnings of the Organization. Form 990, Part VI, Section A, line 6 The Organization is comprised of three permanent member organizations of the Maine Dartmouth Family Medicine Residency: Geisel School of Medicine at Dartmouth, Medical Care Development, Inc, and Maine General Medical Center. Form 990, Part VI, Section A, line 7a The members shall elect the directors according to the rules set forth in the Organization's Bylaws. Those rules state that MGMC has the right to appoint 6 Directors, Geisel has the right to appoint 3 Directors, and MCD has the right to appoint 1 Director. Permanent seats shall be reserved for MDFMR's Executive Director and Resident Representative. Remaining seats shall be filled by a majority vote of the Members. The Members shall elect as many more directors as they deem necessary and proper, no less than or not exceeding the total number of directors allowed by the Articles of Incorporation. The Executive Director of the Residency will be a non-voting member of the Board of Directors. Form 990, Part VI, Section A, line 7b The Organization's member organizations have the ability to nominate other permanent members as well as board members. They also have the ability to change the name of the Corporation, elect the officers of the Board of Directors, and dissolve the Corporation, or merge the Corporation with another corporation. Form 990, Part VI, Section B, line 11b A copy of the 990 is reviewed by the Executive Director before its filing. Additionally, a copy of the Form 990 is given to all members of the board of directors for their review along with a copy of the annual audit. In addition, a copy of the Form 990 is kept in a public review file for anyone requesting a copy. Form 990, Part VI, Section B, line 12c In the fall of every year, all Board members are given the Conflict of Interest policy and asked to sign and declare any potential conflicts. Copies of the statements are given to the Board Chair and the Residency Executive Director for review. Board members with potential conflicts of interest in areas of discussion recuse themselves from discussions and votes. Form 990, Part VI, Section B, line 15 The Residency has written compensation plans for the following: Executive Director, family physicians, nurse practitioner/physician assistants, sports medicine, dermatology, geriatrics, and neuromuscular skeletal. On an annual basis, the Compensation Committee of the Board of Directors, meets to review and approve all compensation plans. The committee is made up of Board of Director members, both non-MDFMR employees and MDFMR employees. MDFMR employees are observers only and do not have voting authority in this process. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Whenever a new Director is voted onto the Board of Directors, a welcome packet is sent to the new Director, with a copy of the Articles of Incorporation, Bylaws, recent Board meetings, latest audited financial statements and conflict of interest form to complete. Form 990, Part X, Line 10: Land, Buildings, and Equipment Section 1.263(a)-3(n) Election: Maine-Dartmouth Family Medicine Residency 15 East Chestnut Street Augusta, ME 04330 EIN 01-0369195 Maine-Dartmouth Family Medicine Residency is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n).